An 8-year-old pediatric client arrives complaining of swelling and pain in the bilateral knees. The child's parent informs the nurse, "The swelling came out of nowhere, and it just keeps getting worse." The initial impression is Lyme disease. Which additional question should be included during the assessment and history?A. "Have you noted any flank pain and a decrease in the urine volume?"B. "Has there been a fever of over 103 degrees over the last two to three weeks?"C. "Have you noticed any rashes on the palms or soles?"D. "Do you have headaches, malaise, or sore throat?"

A 7-year-old girl complains of pain and swelling of the leftwrist and right knee off and on for the past 3 months. Shehas been previously healthy. The pain is worse in themorning and improves throughout the day. Physicalexamination is remarkable for swelling and effusion of theright knee, with decreased range of motion.Which of the following is the most probable diagnosis?a) Septic arthritisb) Polyarticular Juvenile Idiopathic Arthritisc) Systemic onset Juvenile Idiopathic Arthritisd) Systemic lupus erythematosuse) Pauciarticular Juvenile Idiopathic Arthritis

Nursing Intervention for a Client Who Has Lyme Disease

A 6-year-old boy is coming to the OPC with hisparents. He has fever 39°C of 3 days duration. Fourdays ago he got kicked in his left leg while playingfootball. Clinical examination was insignificantexcept for mild swelling, redness and tender of theleft knee.What is your provisional diagnosis?What is your differential diagnosis?a) Joint aspiration.b) Joint ultrasound.c) Hot fomentations and analgesics.

The child was given oral antibiotics and analgesicsand discharged. Two days later, he presented to youwith secondary inability to walk with severeagonizing pain in his left knee. The left knee wasvery tender, swollen, red and hot.• What do you advice?a) Reassure the parents.b) Continue oral antibiotics.c) Hospitalization and IV antibiotics

A 7-year-old child is admitted to the hospital with a medical diagnosis of acute rheumatic fever. Which of the following diversional activities is least desirable to the child during the acute phase of the illness?*1 pointa. Reading a book to the father.c. Watching the television with a sibling.b. Playing with a doll with the nurse.d. Playing checkers with a roommate.